Impact of primary tumor resection in the management of metastatic well-differentiated neuroendocrine tumors of the small bowel and pancreas

Ashley Russo ¹, Timothy DiPeri ¹, Teodora Dumitra ¹

⁰Department of Surgery, Cedars-Sinai Medical Center, California, Los Angeles, USA.

Journal of Neuroendocrinology +

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May 18, 2024

View abstract on PubMed

Summary

Primary tumor resection in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NET) significantly improves overall survival (OS). This surgical approach also shows potential benefits for progression-free survival (PFS), warranting consideration in multidisciplinary care.

Area Of Science

Oncology
Surgical Oncology
Gastroenterology

Background

Gastroenteropancreatic neuroendocrine tumors (GEP-NET) frequently present as advanced disease.
The role of primary tumor resection (PTR) in unresectable metastatic GEP-NET remains debated.
Existing research often relies on large databases with limited treatment specifics.

Purpose Of The Study

To evaluate the impact of primary tumor resection (PTR) on overall survival (OS) and progression-free survival (PFS).
To determine if PTR benefits patients with metastatic well-differentiated GEP-NET.

Main Methods

Retrospective single-institution study (1978-2021).
Included patients with metastatic well-differentiated GEP-NET.
Analyzed OS and PFS using Kaplan-Meier and Cox regression (MVA).

Main Results

PTR was linked to improved median OS in pancreatic NET (PNET) and small bowel NET (SBNET).
Multivariate analysis identified PTR as an independent predictor of improved OS.
PTR showed a trend towards improved PFS in PNET and significant improvement in SBNET.

Conclusions

Primary tumor resection is associated with improved overall survival in metastatic well-differentiated GEP-NET.
PTR may also enhance progression-free survival, particularly in SBNET.
Consideration of PTR within a multidisciplinary setting is recommended for eligible patients.

Keywords:

gastroenteropancreatic neuroendocrine tumor metastatic neuroendocrine tumor neuroendocrine tumor primary tumor resection